Accuracy and Trust of Self-Testing for Bacterial Vaginosis

ArticleinJournal of Adolescent Health 51(4):400–405 · October 2012with19 Reads
DOI: 10.1016/j.jadohealth.2012.01.017
PurposeTwo point-of-care tests are available to detect bacterial vaginosis (BV), a common vaginal condition. This study aimed to (1) compare the accuracy of two self-performed BV tests with clinician-performed BV tests and with clinical diagnosis of BV; and (2) compare trust of results for self-performed BV testing with clinician-performed BV testing.Methods Participants (14–22 years old) in a study assessing self-testing for Trichomonas vaginalis were also asked to perform a self-test for BV (using a pH or sialidase test). Results were compared with clinician-performed tests and with clinical diagnosis of BV (defined by modified Amsel criteria). A two-item subscale from a larger acceptability scale was used to assess trust at baseline, after testing, and after discussion of results.ResultsAll 131 women performed self-BV testing correctly. Agreement between self- and clinician-performed tests was good (κ: .5–.7) Compared with clinical diagnosis of BV, self-pH was 73% sensitive and 67% specific, and self-sialidase was 40% sensitive and 90% specific. Trust in self-performed BV testing was lower than trust in clinician-performed BV testing at baseline, but increased after testing and discussion of results.Conclusions Young women can perform self-tests for BV with reasonable accuracy, which could increase testing when pelvic examinations are not feasible. Trust in self-testing increased after experience and after discussion of test results. Although the pH test is available over the counter, young women may continue to rely on clinicians for testing.
    • "This study was part of a larger cross-sectional study assessing the accuracy and acceptability of self-testing for T. vaginalis, the results of which are detailed in our previous work [22]. This analysis and the original study were approved by the hospital's institutional review board. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Secretory leukocyte protease inhibitor (SLPI) is responsible for regulating inflammatory damage to and innate and adaptive immune responses in the vaginal mucosa. Depressed cervicovaginal SLPI levels have been correlated with both Trichomonas vaginalis infection and poor reproductive health outcomes. Methods: We measured levels of SLPI in 215 vaginal specimens collected from adolescent and young adult females aged 14-22 years. Log-transformed SLPI values were compared by analysis of variance or by an unpaired t test before and after adjustment for confounding effects through the propensity score method. Results: Females receiving hormonal contraceptives and those with an abnormal vaginal pH had lower SLPI levels as compared to their peers. After propensity score adjustment for race, behavioral factors, hormonal use, and other sexually transmitted infections (STIs), SLPI levels were lower in females with a positive T. vaginalis antigen test result, a vaginal pH >4.5, vaginal leukocytosis, and recurrent (vs initial) T. vaginalis infection, with the lowest levels observed in those with the highest T. vaginalis loads. Conclusions: The SLPI level was reduced by >50% in a T. vaginalis load-dependent manner. Future research should consider whether identifying and treating females with low levels of T. vaginalis infection (before they become wet mount positive) would prevent the loss of SLPI and impaired vaginal immunity. The SLPI level could be used as a vaginal-health marker to evaluate interventions and vaginal products.
    Full-text · Article · Jan 2013
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    Full-text · Article · Oct 2013
  • [Show abstract] [Hide abstract] ABSTRACT: Objective: To evaluate the efficiency of Alginate Oligosaccharides antibacterial gel for bacterial vaginosis(BV). Methods: With completely randomized approach, 863 patients with BV were respectively divided into three groups including: metronidazole treatment group, Alginate Oligosaccharides antibacterial gel treatment group and combined treatment group. Result: The clinical effectiveness of three groups at the first follow-up visit was 92.3%, 94.8% and 95.5% respectively(P=0.781), it was 83.0%, 92.6% and 89.9% respectively (P=0.012) at the second follow-up visit; The incidence of adverse reaction was 17.1%, 6.2% and 15.7% respectively (P=0.006). Conclusion: Alginate Oligosaccharides antibacterial gel can effectively improve the clinical symptoms of the patients as metronidazole in treatment of bacterial vaginosis, even more it has better long-term curative effect and fewer adverse reactions, which is worthy of clinical application.
    Article · Jan 2014 · Sexual Health
    W. HouW. HouL. HanL. HanM. LiM. Li+1 more author ...Y. ChenY. Chen
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